WO2012090995A1 - 口腔状態の判定方法、並びにそのために用いられる分析用具、装置、及びプログラム - Google Patents
口腔状態の判定方法、並びにそのために用いられる分析用具、装置、及びプログラム Download PDFInfo
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- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
- G01N33/569—Immunoassay; Biospecific binding assay; Materials therefor for microorganisms, e.g. protozoa, bacteria, viruses
- G01N33/56911—Bacteria
- G01N33/56955—Bacteria involved in periodontal diseases
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- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
- G01N33/5302—Apparatus specially adapted for immunological test procedures
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- G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
- G01N33/543—Immunoassay; Biospecific binding assay; Materials therefor with an insoluble carrier for immobilising immunochemicals
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- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
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- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
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- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
- G01N33/6893—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids related to diseases not provided for elsewhere
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- C12Q2600/00—Oligonucleotides characterized by their use
- C12Q2600/118—Prognosis of disease development
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- C12Q2600/00—Oligonucleotides characterized by their use
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- G01N2800/18—Dental and oral disorders
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- G01N2800/00—Detection or diagnosis of diseases
- G01N2800/50—Determining the risk of developing a disease
Definitions
- the present invention relates to a method for determining the oral condition of a subject, and an analysis tool, apparatus, and program that can be used for the method.
- Oral disease risk is, for example, caries risk, i.e., how susceptible the oral cavity is to caries, and periodontal disease risk, i.e., how susceptible the oral cavity is to periodontal disease Say, etc.
- diagnosis of oral disease risk and oral hygiene status is performed by measuring individual components or properties that reflect oral disease risk and oral hygiene status using saliva and gargle collected from the subject as samples. Based on the results, doctors etc.
- the number of mutans bacteria in saliva or the acid buffer capacity of saliva is known to reflect caries risk. If the number of mutans bacteria is high or the acid buffer capacity is low, the caries risk Is considered high.
- detection methods using antibodies Patent Document 1
- detection methods using resazurin which is an oxidation-reduction indicator (Non-Patent Document 1), and the like are already known.
- occult blood, white blood cells, or alkaline phosphatase are known to reflect the periodontal disease risk. That is, when the gum tissue is destroyed due to periodontal disease, occult blood is detected in the saliva, and leukocytes collect at the affected area of periodontal disease. Alkaline phosphatase is also produced in large quantities from bacteria associated with periodontal disease.
- a hemoglobin contact activation method is known (Patent Document 2).
- a detection method using leukocyte esterase activity or protease activity is known (Patent Document 3).
- an inspection system related to periodontal disease a system is known that can determine whether or not there is periodontal disease by detecting occult blood in saliva. According to this system, an examination in a short time of 5 minutes is possible, but items other than occult blood cannot be examined.
- a system for detecting mutans bacteria and periodontal disease bacteria by PCR using saliva collected at a dental clinic as a sample is known. According to this system, two items, the number of mutans bacteria and the number of periodontal disease bacteria, can be examined simultaneously, but it takes 6 business days to understand the results.
- a detection system for mutans bacteria a system capable of detecting mutans bacteria by measuring the reduction reaction of resazurin by mutans bacteria is known.
- this system can only measure mutans bacteria and requires temperature control at 37 ° C., which takes 15 minutes.
- Non-patent document 2 a system is known in which mutans bacteria in saliva are cultured in a selective medium, and the number of mutans bacteria is determined based on the density of formed colonies.
- this system can only measure mutans bacteria and requires temperature control at 37 ° C., which takes 48 hours.
- JP 2005-241335 A JP-A-2-232561 JP-A-5-168497
- the data obtained by the above method or system only shows information on individual components and properties of the oral cavity, and does not provide any further information. That is, when the above method or system is used, only one or two components or properties are measured for each disease such as “cavities” and “periodontal disease”, and a plurality of parameters are measured for an arbitrary disease. The risk level was not determined based on the measurement results, and the parameters reflecting each of the plurality of diseases were measured, and the risk level was not determined based on the measurement results.
- a doctor or a dental hygienist transmits the measurement result obtained by the above method or system to the subject as it is, or adds knowledge based on experience and judges the measurement result to determine the subject.
- a doctor or the like has been useful for the treatment and prevention of oral diseases. Therefore, the objectivity and accuracy of diagnosis depend on the skills of doctors and the like, and objective and comprehensive diagnosis of oral disease risk and oral hygiene conditions that do not require special skills have not been achieved.
- the measurement time for each item is long, and it was impossible to perform diagnosis and subsequent care guidance in one visit.
- An object of the present invention is to provide means for determining a subject's oral condition, that is, oral disease risk and / or oral hygiene condition.
- the present inventors measured a parameter reflecting caries risk, a parameter reflecting periodontal disease risk, and a parameter reflecting oral cleanliness, and caries risk, periodontal disease risk based on the measurement results. By determining the level of oral cleanliness and providing the determination results to doctors, etc., the doctors can objectively and comprehensively evaluate the oral disease risk and oral hygiene status of the subject without special skills. I thought I could diagnose it. Further, the present inventors have completed the present invention because it is considered that measurement can be performed in a short time and in one inspection by using an analytical tool equipped with a reagent for measuring each of the above parameters.
- the present invention can be exemplified as follows.
- An analytical tool comprising the following (A), (B), and (C).
- A A reagent for measuring one or more parameters reflecting caries risk for a test sample obtained from the oral cavity.
- B A reagent for measuring one or more parameters reflecting periodontal disease risk for a test sample obtained from the oral cavity.
- C A reagent for measuring one or more parameters that reflect oral cleanliness for a test sample obtained from the oral cavity.
- the analysis tool according to [1] wherein the analysis tool is a test piece including a support carrier and an absorbent carrier that holds the reagent carried on the support carrier.
- the analytical tool according to [1] or [2], wherein the parameter reflecting the caries risk includes at least the number of mutans bacteria.
- the parameter reflecting caries risk is a parameter selected from the group consisting of the number of mutans bacteria, pH, and acid buffer capacity
- the parameter reflecting periodontal disease risk is a parameter selected from the group consisting of calcium concentration, total protein concentration, occult blood volume, and white blood cell count
- the parameter reflecting oral cleanliness is based on the ammonia concentration and total protein concentration.
- the analytical tool according to any one of [1] to [4] which has one or more characteristics selected from the following (a), (b), and (c).
- (A) The parameter reflecting the caries risk consists of two or more parameters.
- the parameter reflecting the periodontal disease risk is composed of two or more parameters.
- the parameter reflecting the oral cleanliness is composed of two or more parameters.
- (C) A step of measuring one or more parameters reflecting oral cleanliness for a test sample obtained from the oral cavity, and determining the level of oral cleanliness using the measured parameters as an index. [7] The method according to [6], further comprising displaying the determined level. [8] The method according to [6] or [7], further comprising displaying a comment based on the determined level.
- parameters reflecting the oral condition that is, oral disease risk and / or oral hygiene condition can be measured, and the oral condition can be determined based on the measurement result.
- the caries risk, periodontal disease risk, and / or oral cleanliness level can be determined, and the determination result can be provided to, for example, a doctor or the like and / or the subject. Doctors and the like can objectively and comprehensively diagnose the oral disease risk and / or oral hygiene status of the subject based on the determination result without requiring special skills. Objective explanations can be given to the examiner.
- the subject can objectively understand his / her oral condition based on the determination result. Therefore, the present invention has a great effect on the assistance of diagnosis and treatment by a doctor, and the subject's awareness of prevention and health is also increased.
- the analysis tool or analysis instrument of the present invention it is possible to measure a plurality of components or properties that reflect the oral condition in a short time and a single examination, and immediately have a caries risk and a periodontal disease risk. And / or the level of oral cleanliness.
- a doctor or the like and / or the subject it is possible to perform diagnosis of oral condition and subsequent care guidance in one visit, which has been impossible in the past.
- FIG. 1 (A) is a plan view showing an embodiment of the analytical tool of the present invention
- FIG. 1 (B) is a front view showing an embodiment of the analytical tool of the present invention
- FIG. 2 is a front view showing the structure of the absorbent carrier portion in one embodiment of the analytical tool of the present invention
- FIG. 3 is a block diagram illustrating functions in an embodiment of the apparatus of the present invention.
- FIG. 4 is a flowchart in one embodiment of the program of the present invention.
- FIG. 5 is a graph showing the correlation between the number of mutans bacteria and the reflectance when methoxy PMS is added and not added.
- the oral condition determined in the present invention means an oral disease risk and / or oral hygiene condition.
- the oral disease risk determined in the present invention refers to, for example, a caries risk and a periodontal disease risk.
- the oral hygiene state determined in the present invention refers to, for example, oral cleanliness.
- oral cleanliness does not mean the risk of a specific disease, but in the present invention, the term "risk” collectively refers to caries risk, periodontal disease risk, and oral cleanliness.
- the caries risk level, periodontal disease risk level, and oral cleanliness level may be collectively referred to as “risk level”. For convenience of explanation, it is referred to as “level” in this specification, but it does not have to be a numerical value and may be divided into arbitrary stages.
- the caries risk is a risk that indicates the susceptibility to caries and the ease of progress of caries.
- the caries risk includes not only the potential for the development of potential caries, but also the already developed condition.
- Parameters reflecting caries risk include, for example, the number of mutans bacteria, pH, acid buffer capacity, glucosyltransferase activity, sucrose concentration, glucose concentration, organic acid concentration, lactic acid concentration, and reactivity with mutans antibodies. Can be mentioned.
- one, two or more parameters selected from these parameters are preferably measured.
- the parameter reflecting caries risk it is preferable to measure 1 or 2 or more parameters selected from the group consisting of the number of mutans bacteria, pH, and acid buffering capacity.
- three parameters are measured: number, pH, and acid buffer capacity. Further, as a parameter reflecting caries risk, it is preferable to measure at least the number of mutans bacteria. Measuring a plurality of parameters improves the reliability in determining the level of caries risk.
- Mutans bacteria are so-called carious fungi and are the causative bacteria of caries. Specific examples of mutans bacteria include Streptococcus mutans and Streptococcus sobrinus (S. sobrinus). The higher the number of mutans bacteria, the higher the caries risk.
- the pH of saliva is lowered by the acid produced by mutans bacteria.
- the enamel on the tooth surface dissolves and caries progresses. That is, it is considered that the lower the saliva pH, the higher the caries risk.
- Acid buffering capacity indicates resistance to acid produced by mutans bacteria, and therefore, the lower the acid buffering capacity, the higher the caries risk.
- Periodontal disease risk is a risk that indicates the likelihood of developing periodontal disease and the ease of progression of periodontal disease.
- the periodontal disease risk includes not only the risk of developing a potential periodontal disease but also a state in which it has already developed.
- Parameters reflecting periodontal disease risk include, for example, calcium concentration, total protein concentration, occult blood volume, white blood cell count, alkaline phosphatase activity, nitrite concentration, lactate dehydrogenase activity, lipopolysaccharide concentration, and periodontal disease antibody Examples include reactivity, ⁇ -GTP concentration, albumin concentration, degree of antioxidant, and ⁇ 1-antitrypsin concentration.
- the parameter reflecting periodontal disease risk is 1 or 2 selected from the group consisting of calcium concentration, total protein concentration, occult blood volume, white blood cell count, alkaline phosphatase activity, and lactate dehydrogenase activity, or It is preferable to measure the above parameters, and it is more preferable to measure one or two or more parameters selected from the group consisting of calcium concentration, total protein concentration, occult blood volume, and white blood cell count, It is more preferable to measure one, two, or more parameters selected from the group consisting of occult blood volume and white blood cell count, and it is particularly preferable to measure three parameters: total protein concentration, occult blood volume, and white blood cell count. If a plurality of parameters are measured, the reliability in determining the periodontal disease risk level is improved.
- the degree of destruction of the periodontal tissue can be measured by measuring the degree of occult blood. The more occult blood, the higher the degree of periodontal tissue destruction and the higher the risk of periodontal disease.
- the degree of inflammation of periodontal tissue can be measured by measuring leukocytes. It is considered that the greater the white blood cell count, the higher the degree of inflammation of the periodontal tissue and the higher the risk of periodontal disease.
- Oral cleanliness is the risk of reflecting oral hygiene status regardless of disease.
- parameters that reflect oral cleanliness include ammonia concentration, total protein concentration, total bacterial count, turbidity, viscosity, and secretion amount.
- one, two or more parameters selected from these parameters are preferably measured.
- a parameter reflecting oral cleanliness it is preferable to measure at least one parameter selected from the group consisting of ammonia and total protein concentration, and it is more preferable to measure both parameters of ammonia and total protein concentration. preferable. If a plurality of parameters are measured, the reliability in determining the level of oral cleanliness is improved.
- High ammonia concentration indicates that bacteria are actively breeding in the oral cavity. Moreover, the greater the number of bacteria, the higher the total protein concentration. Therefore, the higher the ammonia concentration and the higher the total protein concentration, the lower the oral cleanliness, that is, the higher the risk.
- the total protein concentration is measured at least once. That's fine. That is, the measurement result of the total protein concentration can be commonly used as the measurement result of the parameter reflecting the periodontal disease risk and the measurement result of the parameter reflecting the oral cleanliness.
- caries risk level is determined by combining one or more parameters reflecting caries risk with one or more parameters reflecting periodontal disease risk and / or oral cleanliness. It is expected to improve the accuracy of determination of the risk level of eating.
- the caries risk level may be determined by combining the number of mutans bacteria, pH, acid buffer capacity, occult blood volume, white blood cell count, ammonia concentration, and total protein concentration. The above description can be applied mutatis mutandis to the determination of periodontal disease risk and oral cleanliness level.
- the caries risk level, periodontal disease risk level, and / or oral cleanliness level an improvement in judgment accuracy is expected.
- Specific examples of the personal data of the subject include age, sex, and the presence or absence of smoking.
- “measuring a parameter” may include a step of acquiring data for calculating an arbitrary parameter, and may include a step of calculating the value of the parameter itself. , It does not have to be included. That is, the value of each parameter can be quantified by each measurement method described later, but quantifying the parameter value itself is not an essential component of the present invention.
- “measuring the number of mutans bacteria” means data used for calculating the number of mutans bacteria, for example, reflectance at an arbitrary wavelength indicating the result of a color reaction reflecting the number of mutans bacteria. It is only necessary to acquire data, and it is not necessary to calculate the number of mutans bacteria from there.
- Measured parameters can be used for risk level judgment.
- “determination” refers to determining a risk level or the like by comparison with a threshold value using a measured parameter as an index. Further, based on the determined risk level, a doctor or the like can diagnose the subject's oral disease risk and / or oral hygiene status. “Diagnosis” means comprehensive judgment by a doctor or the like. Further, “care guidance” refers to guidance based on a diagnosis result performed by a doctor or the like, for example.
- the present invention provides an analysis tool that can be suitably used to measure a parameter reflecting the oral condition.
- the 1st aspect of the analysis tool of this invention is an analysis tool provided with the following (A), (B), and (C).
- C Oral cleanliness for the test sample obtained from the oral cavity
- FIG. 1 shows a test piece 1 which is an embodiment of the first aspect of the analysis tool of the present invention and is configured to measure all three of caries risk, periodontal disease risk, and oral cleanliness. Illustrate.
- FIG. 1A is a plan view of the test piece 1
- FIG. 1B is a front view of the test piece 1.
- FIG. 2 is a front view showing the structure of the absorbent carrier portion of the test piece in one embodiment of the analysis tool of the present invention.
- the test piece 1 includes a support carrier 10, a caries risk measurement unit 11 carried on the support carrier 10, a periodontal disease risk measurement unit 12, and an oral cleanliness measurement unit 13.
- the positional relationship of the measurement parts 11, 12, and 13 is arbitrary.
- the caries risk measurement unit 11 is a part for measuring a parameter reflecting the caries risk of the subject, and includes absorbent carriers 11A, 11B, and 11C.
- the absorbent carriers 11A, 11B, and 11C are absorbent carriers that hold reagents for measuring parameters that reflect caries risk.
- the absorptive carrier 11A holds, for example, a reagent for measuring the number of mutans bacteria for a test sample.
- the absorptive carrier 11B holds, for example, a reagent for measuring the pH of a test sample.
- the absorptive carrier 11C holds, for example, a reagent for measuring the acid buffer capacity of a test sample.
- the caries risk measurement unit 11 includes three absorbent carriers 11A, 11B, and 11C.
- the number of absorbent carriers included in the caries risk measurement unit 11 should be measured. It is increased or decreased depending on the number of parameters reflecting the risk of eating, and usually at least one absorbent carrier is provided for each parameter to be measured.
- the periodontal disease risk measurement unit 12 is a part for measuring a parameter reflecting the periodontal disease risk of the subject and includes absorbent carriers 12A, 12B, and 12C.
- the absorptive carriers 12A, 12B, and 12C are absorptive carriers that hold reagents for measuring parameters that reflect periodontal disease risk.
- the absorbent carrier 12A holds, for example, a reagent for measuring the total protein concentration for a test sample.
- the absorbent carrier 12B holds, for example, a reagent for measuring occult blood for a test sample.
- the absorbent carrier 12C holds, for example, a reagent for measuring the white blood cell count for a test sample.
- the periodontal disease risk measurement unit 12 includes three absorptive carriers 12A, 12B, and 12C, but the number of absorptive carriers included in the periodontal disease risk measurement unit 12 is measured. It is increased or decreased depending on the number of parameters reflecting the periodontal disease risk, and usually at least one absorbent carrier is provided for each parameter to be measured.
- the oral cleanliness measuring unit 13 is a part for measuring a parameter reflecting the oral cleanliness of the subject, and includes absorbent carriers 13A and 13B.
- the absorptive carriers 13A and 13B are absorptive carriers that hold reagents for measuring parameters that reflect oral cleanliness.
- the absorbent carrier 13A holds, for example, a reagent for measuring the ammonia concentration for a test sample.
- the absorptive carrier 13B holds, for example, a reagent for measuring the total protein concentration for a test sample.
- the oral cleanliness measuring unit 13 includes two absorbent carriers 13A and 13B, but the number of the absorbent carriers included in the oral cleanliness measuring unit 13 is the oral cleanliness to be measured. Is increased or decreased depending on the number of parameters reflecting, and usually at least one absorbent carrier is provided for each parameter to be measured.
- parameters reflecting caries risk, parameters reflecting periodontal disease risk, and parameters reflecting oral cleanliness are merely examples, and are not limited to the above parameters. Details of each parameter will be described later.
- FIG. 1 shows an embodiment in which an absorbent carrier for measuring each parameter is aligned by being divided into a caries risk measuring unit 11, a periodontal disease risk measuring unit 12, and an oral cleanliness measuring unit 13.
- the positional relationship of the absorbent carrier for measuring each parameter is arbitrary. That is, the absorptive carrier for measuring each parameter does not have to be divided into each risk measuring unit and aligned.
- the absorbent carriers for measuring each parameter may be linearly aligned or may be aligned in any other sequence.
- the positional relationship of the absorptive carrier for measuring each parameter can be appropriately set according to, for example, whether detection is performed with the naked eye or a detection device is used, and the type of detection device used.
- various reflectance measuring devices can be suitably used as the detecting device.
- Pocket Chem UA PU-4010 manufactured by ARKRAY, Inc.
- absorption for each parameter measurement is performed.
- the sex carriers are preferably aligned in a straight line.
- the test piece of the present invention may include an arbitrary absorbent carrier, for example, a dummy absorbent carrier that is not used for measurement, in addition to the absorbent carrier that holds the measurement reagent for each parameter.
- the analysis tool of the present invention has at least one What is necessary is just to provide the absorptive carrier for total protein concentration measurement. That is, the carrier for measuring the total protein concentration can be commonly used as a carrier for measuring parameters reflecting the periodontal disease risk and a carrier for measuring parameters reflecting the oral cleanliness.
- any carrier can be used as long as it can hold a reagent for measuring each parameter and does not interfere with the measurement. That is, as the absorbent carrier, for example, paper, cellulose, porous ceramic, chemical fiber, synthetic resin woven fabric and nonwoven fabric can be used, and filter paper or glass fiber filter paper is preferable. As filter paper or glass fiber filter paper, for example, commercially available ones can be suitably used.
- the support carrier a film, sheet, or plate carrier can be preferably used.
- the support carrier is preferably made of plastic, and various plastics such as polyethylene, polypropylene, polyester, and polyvinyl chloride can be used as the plastic.
- a polyethylene terephthalate (PET) film is particularly preferable.
- PET polyethylene terephthalate
- the support carrier may be a composite material, and a composite material of polyester and polyethylene, a composite material in which polyethylene and aluminum are laminated, and other various composite materials can be used.
- the thickness of the support carrier is preferably 10 to 500 ⁇ m, more preferably 50 to 300 ⁇ m.
- the absorptive carrier holding the reagent may also serve as an absorptive carrier for spotting the test sample.
- an absorbent carrier for spotting the test sample may be provided.
- FIG. 2 as an example in which an absorptive carrier for spotting a test sample is provided separately from the absorptive carrier for retaining a reagent, an absorptive carrier 14A for retaining a reagent and a test sample are spotted.
- An example in which the absorbent carrier 14 ⁇ / b> B that forms a layered structure is shown.
- the absorptive carrier for holding the reagent and the absorptive carrier for spotting the test sample are in principle. Although it is in contact, for example, when measurement is required without directly contacting the test sample and the reagent, both absorbent carriers can be installed without contacting each other.
- both absorbent carriers can be installed without contacting each other.
- an aspect to install without contacting each other for example, an aspect in which both absorptive carriers are installed with a gap, or an aspect in which another layer is sandwiched between both absorptive carriers, for example, a PET made with fine holes
- interpose a film etc. are mentioned.
- test piece of the present invention may include an arbitrary member, for example, a PET film or the like, between the absorbent carrier holding the reagent and the support carrier.
- the method for producing the test piece of the present invention is not particularly limited, and the test piece of the present invention can be produced by supporting each absorbent carrier on which a measuring reagent for each parameter is held in advance on a support carrier. it can.
- the method of holding the reagent for measuring each parameter on the absorbent carrier is not particularly limited.
- the absorbent carrier may be immersed in the reagent solution, or the reagent solution is spotted or applied to the absorbent carrier. Also good. Of the above, it is preferable to immerse the absorbent carrier in the reagent solution.
- the reagent solution is a solution containing a reagent for measuring an arbitrary parameter.
- the step of holding the reagent on the absorbent carrier may include a plurality of steps such as dipping, spotting or coating.
- the absorbent carrier holding each reagent can be dried and used in the subsequent steps.
- the test piece of the present invention can be produced by cutting the absorbent carrier holding each reagent, if necessary, and supporting it on a support carrier.
- the test piece of the present invention may be manufactured by holding a reagent for measuring each parameter on each absorbent carrier previously supported on a support carrier. In this case, it is preferable that the reagent for measuring each parameter is held on the absorbent carrier by spotting or applying the reagent solution to the absorbent carrier and then dried.
- the method for supporting the absorbent carrier on the support carrier is not particularly limited, and for example, a commonly used adhesion technique can be suitably used. For example, it may be affixed with an adhesive tape or an adhesive.
- each absorptive carrier provided in the test piece of the present invention an absorptive carrier designed according to the measurement method of each parameter can be used. Further, as each absorptive carrier provided in the test piece of the present invention, a known test piece for quantitatively measuring a parameter reflecting caries risk, periodontal disease risk, or oral cleanliness, for example, urine in general A dry test piece used in a test or the like, or a dry test piece used in a blood biochemistry general test or the like may be appropriately modified and used as necessary.
- each measurement reagent may be directly held on the test piece instead of the absorbent carrier.
- maintained directly on a test piece the aspect by which the reagent is hold
- Such a test strip can be produced, for example, by spotting or applying a reagent directly on a support carrier.
- maintained directly on a test piece may be mixed.
- kits including an analysis tool provided with a reagent for measuring each parameter are kits including an analysis tool provided with a reagent for measuring each parameter.
- a test paper for each parameter measurement can be cited.
- a kit including a test paper for measuring each parameter to be measured may be used as the analysis tool of the present invention.
- a test kit for parameter measurement reflecting caries risk, a test paper for parameter measurement reflecting periodontal disease risk, and a test kit for parameter measurement reflecting oral cleanliness It is included in the scope of the analytical tool of the invention.
- the analysis tool included in the measurement kit may be, for example, an analysis tool configured to measure each parameter in any combination.
- the analysis tool for parameter measurement reflecting caries risk may be an analysis tool for measuring two or more parameters reflecting caries risk.
- the analysis tool for parameter measurement reflecting periodontal disease risk may be an analysis tool for measuring two or more parameters reflecting periodontal disease risk.
- the analytical tool for parameter measurement that reflects the oral cleanliness may be an analytical tool for measuring two or more parameters that reflect the oral cleanliness.
- the measurement kit may include an analytical tool for measuring one or more parameters reflecting caries risk and one or more parameters reflecting periodontal disease risk.
- One or more parameters reflecting caries risk and an analytical tool for measuring one or more parameters reflecting oral cleanliness may be included, one or more reflecting oral cleanliness
- An analytical tool for measuring one or more parameters reflecting the above parameters and periodontal disease risk may be included.
- an analytical tool provided with a reagent for measuring each parameter for example, an arbitrary reaction system for measuring each parameter can be mentioned. That is, for example, if the reaction with a reagent is carried out in a container such as a tube, the analysis tool of the present invention can be used with a kit including a reaction container such as a reaction tube containing a reagent for measuring each parameter. Good.
- a reaction tube containing a parameter measurement reagent that reflects caries risk a reaction tube containing a parameter measurement reagent that reflects periodontal disease risk
- a parameter measurement reagent that reflects oral cleanliness The measurement kit including the reaction tube is included in the scope of the analysis tool of the present invention.
- the method for measuring each parameter is not particularly limited, and can be appropriately set by those skilled in the art.
- a newly developed method may be used, or a known method may be used.
- a method for measuring parameters that can be measured in the present invention will be exemplified.
- the number of mutans bacteria is not particularly limited, and can be measured by, for example, a method using a resazurin reduction reaction or a method using an antibody against mutans.
- the number of mutans bacteria is preferably measured by a method using a reduction reaction of resazurin.
- the method using the reduction reaction of resazurin is referred to as resazurin method.
- Resazurin is a redox indicator and is usually present as resazurin (maximum absorption wavelength 605 nm) which is an oxidized blue pigment, but is reduced by NADH produced by the metabolism of Gram-positive bacteria including mutans bacteria, and a red-purple pigment ( It is converted into resorufin having a maximum absorption wavelength of 573 nm. That is, resazurin reduction proceeds according to the number of viable mutans bacteria.
- the measurement reagent when the resazurin method is used preferably further contains 1-methoxy-5-methylphenazinium methyl sulfate (methoxy PMS).
- methoxy PMS When methoxy PMS is contained, it is effective for measurement under reaction conditions for a short time at room temperature as compared with the case where methoxy PMS is not contained.
- concentration of the reagent can be appropriately set, but the concentration of methoxy PMS in the reagent solution in which the absorbent carrier is immersed is preferably 0.1 to 1 mM, more preferably 0.1 to 0.5 mM. is there.
- a test paper prepared by the following procedure can be used on a support carrier.
- the reagent solution contains 30 mM sucrose, 0.2% polyvinyl alcohol, 100 mM phosphate buffer (pH 6), 0.1 mM methoxy PMS, and 0.12 mM resazurin.
- the filter paper is dried at 50 ° C. for 15 minutes.
- the reaction time can be appropriately set, but is preferably 1-10 minutes.
- the detection conditions at the time of detecting with a detection apparatus can be set suitably.
- the measurement wavelength is 635 nm and the reference wavelength is 760 nm with a reaction time of 5 minutes.
- the progress of the resazurin reduction reaction is detected as a decrease in absorbance at 635 nm, that is, as an increase in reflectance when irradiated with 635 nm light.
- the consumption of resazurin can be calculated, and the number of mutans bacteria can be calculated from the consumption of resazurin.
- all of the resazurin reduction reactions may be mutans bacteria.
- the pH of saliva is not particularly limited, but it is preferably measured with a pH indicator, for example.
- a pH indicator any known pH indicator can be used. It is preferable to use a pH indicator having a color change range in the range of pH 2 to 9, and a pH indicator having a color change range in the range of pH 3 to 8 is used. Is more preferable.
- a pH indicator a plurality of pH indicators may be mixed and used as necessary. For example, a composite reagent of bromocresol green and bromoxylenol blue can be suitably used. The concentration of the pH indicator can be appropriately set.
- the concentration of bromocresol green in the reagent solution in which the absorbent carrier is immersed is preferably 0.1 to 0.6 mM, more preferably 0.1 to 0.
- the concentration of bromoxylenol blue is preferably 0.6 to 2 mM, more preferably 0.8 to 1.8 mM.
- test paper for measuring pH of Auston Sticks can be used as an absorptive carrier for measuring pH with a pH indicator.
- the test paper contains 0.07 mg of bromocresol green and 0.72 mg of bromoxylenol blue per 100 sheets.
- the reaction time can be appropriately set, but is preferably 30 seconds to 5 minutes.
- the detection conditions at the time of detecting with a detection apparatus can be set suitably.
- a test paper for pH measurement of Aushon Sticks manufactured by ARKRAY, Inc.
- Pocket Chem UA PU-4010 manufactured by ARKRAY, Inc.
- measurement can be performed at a measurement wavelength of 635 nm and a reference wavelength of 760 nm. Based on the measurement result, the pH can be calculated.
- the acid buffering ability of saliva is not particularly limited, but for example, it is preferably measured using a pH indicator.
- a pH indicator As a measurement principle, by contacting a test sample with an absorbent carrier containing an acidic buffer and a pH indicator in advance, the indicator pH of the indicator approaches the original pH of saliva as the acid buffering capacity increases, The lower, the closer to the acidic range than the original pH of saliva is utilized.
- the pH indicator any known pH indicator can be used. It is preferable to use a pH indicator having a color change range in the range of pH 2 to 9, and a pH indicator having a color change range in the range of pH 3 to 8 is used. Is more preferable.
- a pH indicator a plurality of pH indicators may be mixed and used as necessary.
- a composite reagent of bromocresol green and bromoxylenol blue can be suitably used.
- the acidic buffer for example, a non-volatile organic acid can be preferably used.
- the non-volatile organic acid include citric acid, malic acid, tartaric acid, malonic acid, oxalic acid, sulfosalicylic acid, sulfanilic acid, benzoic acid, and tricarballylic acid. Of these, tartaric acid is more preferable.
- an inorganic acid such as metaphosphoric acid can be used.
- the acidic buffer may be a buffer such as a mixture of potassium hydrogen phthalate and potassium phosphate.
- concentration of the reagent can be appropriately set.
- the concentration of bromocresol green in the reagent solution in which the absorbent carrier is immersed is preferably 0.1 to 0.6 mM, more preferably 0.1 to 0.00. 4 mM
- the concentration of bromoxylenol blue is preferably 0.6-2 mM, more preferably 0.8-1.8 mM
- the concentration of tartaric acid is preferably 0.1-10 mM, more preferably 1-6 mM. is there.
- a test paper prepared by the following procedure can be used by placing it on a support carrier.
- the reagent solution contains 0.2 mM bromocresol green, 1.2 mM bromoxylenol blue, 0.05% polyoxyethylene sorbitan monolaurate, 0.5% hydroxypropylcellulose, 2 mM tartaric acid.
- the filter paper is dried at 50 ° C. for 15 minutes.
- the reaction time can be appropriately set, but is preferably 30 seconds to 5 minutes.
- the detection conditions at the time of detecting with a detection apparatus can be set suitably.
- the pH measurement test paper of Aushon Sticks (Arkray Co., Ltd.) is used as an absorbent carrier for acid buffer capacity measurement as described above, and Pocket Chem UA PU-4010 (Arkray Co., Ltd.) is used as a detection device.
- the measurement of the calcium concentration is not particularly limited, but is preferably performed by, for example, a chelate method.
- the chelate method is a calcium measurement method that utilizes the change in color tone when calcium binds to a chelating color former.
- the O-CPC method is preferably used.
- the O-CPC method is a measurement method using ortho-cresolphthalein complexone (O-CPC) as a chelating color former, and O-CPC reacts with calcium under alkaline conditions to form a deep red chelate compound Is generated.
- an absorptive carrier for calcium concentration measurement by the chelate method for example, a test paper contained in Spotchem II calcium (manufactured by Arkray, Inc.), which is a calcium concentration measurement kit, can be used.
- the test paper contains 2.6 mg of O-CPC per 100 sheets.
- the reaction time can be appropriately set, but is preferably 1 to 5 minutes.
- the detection conditions at the time of detecting with a detection apparatus can be set suitably.
- a test paper contained in Spotchem II calcium (Arkray Co., Ltd.) as an absorbent carrier for measuring calcium concentration and using Pocket Chem UA PU-4010 (Arkray Co., Ltd.) as a detection device
- measurement can be performed with a measurement wavelength of 565 nm and a reference wavelength of 760 nm. Based on the measurement result, the amount of the chelate compound can be calculated, and the calcium concentration can be calculated from the amount of the chelate compound.
- occult blood is not particularly limited, but is preferably performed by, for example, a hemoglobin contact activity method.
- Hemoglobin contact activation method is the ability of blood components hemoglobin, myoglobin, or their degradation products to catalyze the transfer of oxygen from oxygen donors such as peroxides to the oxygen acceptor (peroxidase-like activity) ) Is used.
- oxygen donors such as peroxides to the oxygen acceptor (peroxidase-like activity)
- occult blood can be detected through detection of hemoglobin and the like by measuring the color reaction.
- the indicator is not particularly limited as long as it exhibits a color reaction with blood components such as hemoglobin, myoglobin, or their degradation products.
- anilines, phenols, o-toluidine, p-toluidine, o-phenylenediamine, N, N′-dimethyl-p-phenylenediamine, N, N′-diethyl-p-phenylenediamine, p-anisidine, dianisidine, o-tolidine, o-cresol, m-cresol, p-cresol, ⁇ -naphthol, ⁇ -naphthol, catechol, guaiacol, pyrogallol and the like can be used.
- the phenol for example, 3,3 ′, 5,5′-tetramethylbenzidine (TMBZ) can be preferably used.
- oxygen donor peroxides
- peroxides for example, cumene hydroperoxide, diisopropylbenzene peroxide, paramentane hydroperoxide, 2,5-dimethylhexane-2,5-dihydroperoxide and the like are preferable.
- cumene hydroperoxide can be suitably used as the oxygen donor.
- test paper for measuring occult blood of AUTION Sticks can be used as an absorptive carrier for measuring occult blood by the hemoglobin contact activity method.
- the test paper contains 30.0 mg cumene hydroperoxide and 15.0 mg TMBZ per 100 sheets.
- the reaction time can be appropriately set, but is preferably 30 seconds to 5 minutes.
- the detection conditions at the time of detecting with a detection apparatus can be set suitably.
- Measurement can be performed at a measurement wavelength of 635 nm with a reaction time of 60 seconds. Based on the measurement result, the hemoglobin concentration can be calculated, and the occult blood volume can be calculated from the hemoglobin concentration.
- the measurement of the white blood cell count is not particularly limited, but it is preferably performed by, for example, the white blood cell esterase method.
- the leukocyte count can be calculated by measuring the esterase activity.
- the leukocyte esterase method directly colors the alcohol (phenol) component produced by hydrolysis of the ester compound used as a substrate by the esterase (leukocyte esterase) produced by leukocytes, or This is a technique for measuring the white blood cell count by coupling with a diazonium salt to cause coloration.
- ester compound used as a substrate sulfophthalein esters or azo dye esters can be used for direct coloring, and phenoxy-amino acid for coupling with other indicators for coloring.
- Esters, indoxyl esters, phenylpyroxyl esters, and the like can be used.
- indoxyl esters for example, 3- (N-toluenesulfonyl-L-alanyloxy) indole (TAI) can be preferably used.
- a diazonium salt can be used as an indicator in the case of color formation by coupling.
- 2-methoxy-4- (N-morpholino) benzenediazonium salt can be preferably used.
- the indoxyl produced by the reaction is coupled with, for example, 2-methoxy-4- (N-morpholino) benzenediazonium salt (MMB). It can be colored by ringing.
- MMB 2-methoxy-4- (N-morpholino) benzenediazonium salt
- a test paper for leukocyte measurement of Auston Sticks (manufactured by ARKRAY, Inc.) can be used.
- the test paper contains TAI 0.49 mg and MMB 0.17 mg per 100 sheets.
- the reaction time can be appropriately set, but is preferably 30 seconds to 5 minutes.
- the detection conditions at the time of detecting with a detection apparatus can be set suitably.
- a white blood cell measurement test paper manufactured by Ortion Sticks manufactured by ARKRAY, Inc.
- Pocket Chem UA PU-4010 manufactured by ARKRAY, Inc.
- measurement can be performed at a measurement wavelength of 565 nm and a reference wavelength of 760 nm. Based on the measurement results, the esterase activity can be calculated, and the white blood cell count can be calculated from the esterase activity.
- the measurement of the total protein concentration is not particularly limited, but is preferably performed by, for example, a protein error method.
- the protein error method is a protein measurement method that utilizes the fact that a pH indicator shows a pH higher than the true pH of a solution in proportion to the protein concentration.
- pH indicators examples include tetrabromophenol blue (TBPB), tetrabromophenol phthalene, 5 ′, 5 ′′ -dinitro-3 ′, 3 ′′ -diiodo-3,4,5,6.
- TBPB tetrabromophenol blue
- DIDNTB tetrabromophenol sulfophthalein
- Coomassie brilliant blue first green FCF, light green SF and the like (for example, see US Patent No. 40141316)
- tetrabromophenol blue is preferably used.
- the indicator is insoluble in water
- the reagent solution may be prepared using an organic solvent such as acetone, ethanol, methyl cellosolve, or the like.
- an acidic buffer as a pH buffer.
- a non-volatile organic acid can be preferably used.
- the non-volatile organic acid include citric acid, malic acid, tartaric acid, malonic acid, oxalic acid, sulfosalicylic acid, sulfanilic acid, benzoic acid, A tricarballylic acid is mentioned.
- an inorganic acid such as metaphosphoric acid can be used as the acidic buffer.
- the acidic buffer may be a buffer such as a mixture of potassium hydrogen phthalate and potassium phosphate.
- concentration of the acidic buffer is preferably sufficient to prevent the protein error indicator from discoloring when in contact with the sample, even if no significant amount of protein is present in the sample. Or 50 to 1500 mM, more preferably 1000 to 1200 mM, in the reagent solution to be applied.
- a test paper for protein measurement of AUTION Sticks (manufactured by ARKRAY Inc.) can be used.
- the test paper contains 0.35 mg of TBPB per 100 sheets.
- the reaction time can be appropriately set, but is preferably 30 seconds to 5 minutes.
- the detection conditions at the time of detecting with a detection apparatus can be set suitably.
- the protein measurement test paper of Aushon Sticks As an absorbent carrier for protein measurement
- Pocket Chem UA PU-4010 As a detection device
- measurement can be performed at a measurement wavelength of 635 nm and a reference wavelength of 760 nm. Based on the measurement result, the total protein concentration can be calculated.
- the quantification of ammonia is not particularly limited, but is preferably performed by, for example, a micro-diffusion method (Conway method).
- the micro-diffusion method is a method used for quantification of ammonia nitrogen, and is a method of trapping a component that volatilizes from a sample in an absorption solution or the like and quantifying it by a method such as colorimetry.
- the absorption of spotting the test sample is separated from the absorbent carrier (reagent layer) holding the reagent at the ammonia determination site in the test piece of the present invention.
- An absorptive carrier (sample layer) is provided, and both absorptive carriers are placed so as not to contact each other. Both absorptive carriers are installed so as not to contact each other, for example, by sandwiching a PET film having fine holes between both absorptive carriers.
- the sample layer also holds an alkaline buffer, such as a borate buffer. When the test sample is spotted on the sample layer of the test piece, the alkaline buffer in the sample layer is dissolved, and the sample becomes alkaline. Ammonium ions in the sample become ammonia molecules under alkaline conditions, volatilize as ammonia gas, and move to the reagent layer through, for example, a hole in the spacer. The indicator in the reagent layer reacts with ammonia gas and develops color.
- any known pH indicator can be used.
- the pH indicator for example, bromcresol green, bromcresol purple, chlorophenol red and the like are used, and bromcresol green is preferably used.
- a test paper included in Amicheck which is an ammonia measurement kit
- the test paper contains 42.6 mg boric acid and 18.7 mg sodium hydroxide per 100 sheets, and 4.0 mg bromcresol green in the reagent layer.
- the reaction time can be appropriately set, but is preferably 10 seconds to 5 minutes.
- the detection conditions at the time of detecting with a detection apparatus can be set suitably.
- a test paper included in Amicheck Arkray Co., Ltd.
- Pocket Chem UA PU-4010 Arkray Co., Ltd.
- the sample layer and the spacer are peeled off from the reagent layer 20 seconds after the sample is spotted on the sample layer, and after 60 seconds, the reagent layer can be measured at a measurement wavelength of 635 nm. Based on the measurement result, the ammonia concentration can be calculated.
- the measurement of lactate dehydrogenase activity is not particularly limited, and is performed, for example, by the formazan method.
- the formazan method is a technique in which lactate dehydrogenase uses NAD as a coenzyme, and NADH produced by oxidizing lactate dissolves diaphorase to reduce the tetrazolium salt to formazan, which is a color substance.
- tetrazolium violet can be suitably used as the tetrazolium salt.
- alkaline phosphatase activity is not particularly limited, but is performed, for example, by the p-nitrophenyl phosphate method.
- the p-nitrophenyl phosphate method is a technique for quantifying p-nitrophenol, which is a color substance, produced by hydrolysis of p-nitrophenyl phosphate, which is a substrate by alkaline phosphatase.
- the above measurement methods can be preferably used in the absorbent carrier provided on the test piece of the present invention.
- each of the above measuring methods is not limited to the case of using a test piece provided with an absorbent carrier, for example, when using a test piece not provided with an absorbent carrier or when reacting with a sample in a container such as a tube.
- the reagent concentration, reaction time, etc. can be appropriately set and used. Therefore, the analysis tool of the present invention is preferably used for measuring parameters reflecting caries risk, periodontal disease risk, and oral cleanliness in a short time and in one inspection. Further, if the analysis tool of the present invention is used, objective, reproducible and reliable measurement can be performed without depending on the inspection technique of an inspection engineer or a doctor.
- the analysis tool of the present invention is configured to be able to measure parameters reflecting caries risk, periodontal disease risk, and oral cleanliness as described above. That is, for example, the analysis tool of the present invention can measure one or more parameters selected from the group consisting of the number of mutans bacteria, pH, and acid buffering capacity as parameters that reflect caries risk, and thereby the risk of periodontal disease.
- One or more parameters selected from the group consisting of calcium concentration, total protein concentration, occult blood volume, and white blood cell count can be measured as parameters that reflect the amount of ammonia, and ammonia concentration and total protein concentration as parameters that reflect oral cleanliness
- one or more parameters selected from the group consisting of can be measured.
- the analytical tool of the present invention can measure the number of mutans bacteria, pH, and acid buffering capacity as parameters reflecting caries risk, and the calcium concentration, total protein concentration, occult blood volume as parameters reflecting periodontal disease risk It is also preferable that the white blood cell count can be measured and the ammonia concentration and the total protein concentration can be measured as parameters reflecting the oral cleanliness. Moreover, it is particularly preferable that the analysis tool of the present invention is configured to measure all seven parameters including the number of mutans bacteria, pH, acid buffer capacity, occult blood volume, white blood cell count, ammonia concentration, and total protein concentration.
- the second aspect of the analysis tool of the present invention is an analysis tool provided with a reagent for measuring two or more parameters reflecting caries risk for a test sample obtained from the oral cavity.
- a third aspect of the analysis tool of the present invention is an analysis tool provided with a reagent for measuring two or more parameters reflecting periodontal disease risk for a test sample obtained from the oral cavity, for example. .
- a fourth aspect of the analysis tool of the present invention is an analysis tool provided with a reagent for measuring two or more parameters that reflect oral cleanliness, for example, for a test sample obtained from the oral cavity.
- the first aspect of the measuring device of the present invention is that (A) the test sample obtained from the oral cavity has one or more parameters reflecting the caries risk, the risk of periodontal disease. One or more parameters to reflect and a measurement unit that measures one or more parameters that reflect oral cleanliness, (B) from the results measured by the measurement unit, caries risk, periodontal disease risk, and It is a measuring apparatus provided with the display part which displays the risk level determined by the risk level determination part which determines the level of oral cleanliness, (C) risk level determination part as a character, a figure, a symbol, color, or these combination.
- the measurement apparatus of the present invention is a measurement apparatus further including (D) a display unit that displays a comment based on the risk level determined by the risk level determination unit.
- D a display unit that displays a comment based on the risk level determined by the risk level determination unit.
- the measuring device 2 includes a measuring unit 21.
- the measurement unit 21 is a part that acquires measurement data of each parameter. For example, when measuring each parameter using the test piece of the present invention, the measurement unit 21 measures the progress of the color reaction in each absorbent carrier provided in the test piece of the present invention.
- the progress of the color reaction can be measured based on the absorbance at a specific wavelength.
- reflectance data correlated with the progress of the color reaction may be acquired.
- the reflectance data may be, for example, a reflectance value at a specific wavelength after a predetermined time has elapsed since the test sample was brought into contact with the measurement reagent of each parameter.
- the reflectance value can be obtained by irradiating a colored portion, for example, an absorbent carrier portion spotted with a test sample, and measuring the reflected light.
- the reflectance data may be, for example, a value obtained by dividing the reflectance value obtained as described above from 100%. Note that the higher the absorbance at a specific wavelength, the lower the reflectance value at the specific wavelength, and the lower the absorbance at the specific wavelength, the higher the reflectance value at the specific wavelength.
- the fixed time may be, for example, the reaction time in each parameter measurement method as described above, and may be set as appropriate according to the type of parameter to be measured and the measurement method.
- the reflectance data may be, for example, a change value of the reflectance over a certain time at a specific wavelength.
- the reflectance change value can be obtained by irradiating a colored portion, for example, an absorbent carrier portion spotted with a test sample, and measuring the increase or decrease of the reflected light. .
- An increase in absorbance at a specific wavelength can be measured as a decrease in reflectance at the specific wavelength.
- the decrease in absorbance at a particular wavelength can be measured as an increase in reflectance at that particular wavelength.
- the certain period of time may be from the time immediately after the test sample is deposited until a certain time elapses, or from a certain time after the test sample is deposited until a certain time elapses. .
- the change value of the reflectance can be calculated as a difference between measured values obtained by measuring the reflectance at least twice. Further, the change value of the reflectivity over a certain period of time may be calculated as the change rate of the reflectivity based on the reflectivity measured a plurality of times. It should be noted that immediately after the test sample is deposited or after the test sample is deposited, such as when the reflectance is assumed to be constant immediately after the test sample is deposited or at a certain time after the test sample is deposited. If it is not necessary to measure the reflectance at the time, the number of reflectance measurements may be reduced.
- Which of the above values should be used as the reflectance data may be appropriately set according to the type of parameter to be measured and the measurement method. For example, when measuring the number of mutans bacteria by the resazurin method, it is preferable to measure the change in reflectance. Specifically, for example, when the number of mutans bacteria is measured by the resazurin method, if the reaction time is 5 minutes, the change in reflectance during 4 minutes from 1 to 5 minutes after the start of the reaction may be measured. . Also, for example, when measuring a parameter whose reflectance decreases as the parameter deteriorates at a specific wavelength, the reflectance value is used. When measuring a parameter whose reflectance increases as the parameter deteriorates, for example.
- the reflectance at a measurement wavelength of 635 nm increases as the pH deteriorates, that is, becomes acidic.
- the wavelength of the light source used to acquire the reflectance data can be set as appropriate based on the measurement method of each parameter and the detection device used. Further, the measurement wavelength and the reference wavelength for removing the influence of the background may be individually set and used.
- Each parameter may be measured sequentially, or a plurality of parameters may be measured simultaneously by an apparatus having a plurality of photometric parts.
- the measuring device 2 includes a control unit 23.
- the control unit 23 includes a CPU and a RAM, and a risk level determination unit including a rank determination unit 231A and two risk level determination units 231B and 231C, which will be described later, by the CPU interpreting and executing a program expanded in the RAM. 231 and the comment determination unit 232.
- the program is stored in a program storage unit 241 of the storage unit 24 described later.
- the risk level determination unit 231 is included in the control unit 23, and includes a rank determination unit 231A and two risk level determination units 231B and 231C.
- the rank determination unit 231A is based on a table in which the correlation between the rank of the parameter reflecting the caries risk, periodontal disease risk, or oral cleanliness stored in the storage unit 24 to be described later and the reflectance data is set.
- the rank of each parameter is determined for the test sample.
- the rank of the mutans bacteria count is determined for the test sample based on a table in which the correlation between the rank of the mutans bacteria count and the reflectance data is set.
- the rank to be judged is two or more levels, preferably 3 to 8 levels.
- the risk level determination unit 231B is a parameter determined by the rank determination unit 231A based on a table in which the correlation between the rank of each parameter stored in the storage unit 24 described later and the level of risk reflected by the parameter is set. It is determined which risk level corresponds to the risk that the parameter reflects. For example, based on a table showing the correlation between the rank of the number of mutans bacteria and the level of caries risk, the determination rank of the number of mutans bacteria determined by the rank determination unit 231A corresponds to which risk level in the caries risk. To determine.
- the risk level determination unit 231C calculates the level of the risk for each risk based on the risk level in the risk of the parameter reflecting the risk determined by the risk level determination unit 231B.
- the caries risk level of the subject is determined based on the risk level in the caries risk of the mutans bacteria count, pH, and acid buffer capacity determined by the risk level determination unit 231B.
- the risk level is 2 or more, preferably 3 to 6.
- the risk level determination unit 231 is shown as an aspect including a rank determination unit 231A and two risk level determination units 231B and 231C, but each risk is obtained by the measurement unit 21.
- the risk level is determined based on the measurement result of the parameter reflecting the risk, any mode may be used.
- the risk level is determined directly from each reflectance data without determining the rank. May be.
- the risk level determination unit 231 may determine the risk level of a certain risk by combining a parameter corresponding to a certain risk and a parameter corresponding to another risk. For example, the risk level determination unit 231 combines the one or more parameters that reflect the caries risk with one or more parameters that reflect the periodontal disease risk and / or oral cleanliness. A determination may be made. Moreover, the risk level determination part 231 may determine the risk level of each risk by combining the parameter corresponding to each risk and the personal data of the subject.
- the comment determination unit 232 is included in the control unit 23, and the risk level determined by the risk level determination unit 231C based on a table indicating the correlation between the risk level and the comment in each risk stored in the storage unit 24 described later. Select the comment corresponding to.
- the measuring device 2 includes a display unit 22.
- the display unit 22 is an aspect of the output in the present invention.
- the measurement value obtained by the measurement unit 21, the rank determined by the rank determination unit 231A, the risk level determined by the risk level determination unit 231C, and the comment determination unit This is a part for displaying the comment selected in H.232.
- the display unit 22 is not particularly limited as long as it can display information such as characters and images. For example, a liquid crystal display including an LED backlight is preferably used.
- the display by the display unit 22 is performed in any format such as characters, figures, symbols, colors, or combinations thereof.
- the display unit 22 can individually display information such as measurement results of each parameter, determination rank, each risk level, and comments corresponding thereto, if necessary.
- the information may be collectively displayed in an arbitrary form such as a character, a figure, a symbol, a color, or a combination thereof so as to assist in the diagnosis.
- the display unit 22 is adopted as one aspect of the output in the present invention, but the output may be any output form that can be recognized by a doctor, a dental hygienist, or a subject, for example, printing Or may be output by voice.
- information may be output by arbitrarily combining visual display on the display unit, output by printing, output by sound, and the like.
- the parameter value is calculated from the reflectance data of each parameter obtained by the measuring unit 21 based on calibration curve data (not shown) indicating the correlation between the parameter and the reflectance data. May be. That is, for example, the number of mutans bacteria in a test sample may be calculated based on calibration curve data (not shown) indicating the correlation between the number of mutans bacteria and reflectance data.
- a comment corresponding to the rank of each parameter determined by the rank determination unit 231A may be selected based on a table indicating the correlation between the rank of each parameter and the comment. Further, the selected comment may be output.
- the measuring device 2 includes a storage unit 24.
- the storage unit 24 includes a program storage unit 241 and a measurement data storage unit 242.
- the program storage unit 241 stores a program developed in the RAM of the control unit 23 and executed by the CPU.
- the measurement data storage unit 242 stores measurement value data obtained by the measurement unit 21. It is also preferable that the storage unit 24 further stores the results determined by the rank determination unit 231A and the risk level determination units 231B and 231C. Further, the storage unit 24 may store basic information such as that stored in a conventional measuring apparatus such as subject information such as the name of the subject and contact information.
- the reflectance measuring device for urine test paper or blood test paper can be customized according to the analytical tool of the present invention and its measurement items.
- a reflectance measuring instrument for urine test paper for example, Pocketchem UA PU-4010 (manufactured by ARKRAY, Inc.) can be used.
- Pocket Chem UA PU-4010 it is possible to perform measurement by two-wavelength reflection photometry.
- the photometry unit irradiates the colored part with two types of light having different wavelengths from the multi-LED, that is, the light of the measurement wavelength and the light of the reference wavelength. Color development can be measured.
- the measuring device of the present invention may or may not be a stand-alone device. That is, each unit may be physically independent as long as data can be transmitted and received with each other.
- the measurement data may be transmitted to another device using an electric communication line or the like, and the risk level may be determined by the other device.
- the determined risk level may be transmitted to another device using a telecommunication line or the like, and information such as a risk level determined by the other device and a comment based thereon may be displayed.
- reflectance data for measuring each parameter using a test piece including an absorbent carrier that holds a reagent for measuring each parameter which is an embodiment of the analysis tool of the present invention.
- the method for measuring each parameter is not limited to the case of using a test piece with an absorbent carrier, for example, when using a test piece without an absorbent carrier or in a container such as a tube.
- it can also be used when reacting with a sample. That is, without using the test piece of the present invention, for example, by adding a test sample into a reaction tube containing a reagent for measuring an arbitrary parameter, the color reaction proceeds to obtain reflectance data. Is also possible. Therefore, in the present invention, the step of “measuring parameters” can be performed using the analytical tool of the present invention.
- a second aspect of the measuring apparatus of the present invention is a measuring apparatus provided with the following (A) to (C).
- a third aspect of the measuring apparatus of the present invention is a measuring apparatus provided with the following (A) to (C), for example.
- a fourth aspect of the measuring apparatus of the present invention is a measuring apparatus provided with the following (A) to (C), for example.
- the 1st aspect of the program of this invention is a program which makes a computer perform the following steps (A) and (B).
- the program of the present invention may further cause the computer to execute the following step (C).
- step (C) A step of displaying a comment on the display unit based on the level determined in step (A).
- the program of the present invention can cause the measuring apparatus of the present invention to execute the above steps, for example.
- FIG. 4 shows steps executed by a computer according to the present invention in an embodiment of the program according to the present invention.
- the analysis tool of the present invention is set in the apparatus 2, and the reflectance data of each absorbent carrier is measured by the measuring unit 21.
- the measured reflectance data is stored in the measurement data storage unit 242.
- step S1 each risk level is determined based on the data acquired by the measurement unit 21.
- Step S1 includes steps S11, S12, and S13.
- the rank determination unit 231A is based on a table in which correlation between the rank of the parameter reflecting the caries risk, periodontal disease risk, or oral cleanliness stored in the storage unit 24 and the reflectance data is set. Then, the rank of each parameter is determined for the test sample.
- the rank to be judged is two or more levels, preferably 3 to 8 levels.
- the reflectance data value of an arbitrary parameter acquired by the measurement unit 21 is x, and the rank is divided into n stages (n is an arbitrary integer). , Any integer satisfying n ⁇ m), and the threshold value of the reflectance data value is t m .
- step S11 ends, the process proceeds to step S12.
- step 12 the risk level determination unit 231B determines the risk level corresponding to the parameter based on a preset table for the rank of the parameter determined in step 11. .
- step S13 the risk level determination unit 231C determines the risk level of the risk reflected by the parameter based on the risk level of the parameter determined in step S12.
- the risk level is 2 or more, preferably 3 to 6.
- the largest value is used as p among the corresponding risk levels.
- the risk level corresponding to the rank of mutans bacteria is 4
- the risk level corresponding to the pH rank is 2
- the risk level corresponding to the acid buffer capacity rank is 3.
- the risk level of the risk is determined based on the parameter having the maximum corresponding risk level. Is not particularly limited as long as the risk level is determined based on a parameter reflecting an arbitrary risk. For example, an average value of risk levels corresponding to the rank of the one or more parameters is calculated, and the risk level is calculated based on the average value. May be determined. Further, when an arbitrary risk level is determined based on the measurement results of a plurality of parameters, the measurement results of the plurality of parameters may be handled with equal weights or may be handled with weights. . The weighting can be set based on, for example, the importance of the parameter for an arbitrary risk.
- the measurement result of the mutans bacteria count is more strongly reflected than the measurement results of the other two parameters.
- the level of erosion risk may be determined.
- the contents of the determination step can be set as appropriate. Good.
- step S1 the process proceeds to step S2.
- step S2 the display unit 22 displays the risk level determined in step S13 in an arbitrary format.
- Examples of the format in which the risk level is displayed include numerical values, figures, and tables.
- the graphic is not particularly limited, and can be displayed as a graphic in an arbitrary format such as a bar graph or a radar chart.
- step S1 ends, the process proceeds to step S3.
- the comment determination unit 232 selects a comment corresponding to the risk level determined in step S13, and the display unit 22 displays the selected comment.
- the comment indicates, for example, what kind of response should be taken clinically for each risk.
- a comment regarding caries risk, it can be said that “Muscle toothbacteria are detected at a high level, the acid buffering capacity of saliva is weak, and the risk of tooth decay is high. Be sure to clean the mouth after meals.
- step S ⁇ b> 1 includes step S ⁇ b> 11, step S ⁇ b> 12, and step S ⁇ b> 3 is shown, but for each risk, the measurement result of the parameter that reflects the risk obtained by the measurement unit 21.
- step S1 may be in any form.
- the risk level may be determined from the reflectance data without determining the rank.
- Correlation data used for each process such as the correlation between the rank of parameters for determining the rank and the reflectance data, the correlation between the rank and the risk level for determining the risk level from the rank, is used for oral examination and dental practice.
- the measured value of each parameter of the oral test sample obtained from a large number of subjects and each risk are compared with the diagnosis of the dentist and statistical processing is performed.
- the numerical value of each risk level and the test sample It is created by associating with the measured value of each parameter.
- Table 1 shows an example of the value of each parameter and the corresponding risk level when the risk level is classified into three levels for each parameter.
- the value of the acid buffer capacity indicates the final pH value when a sample obtained from the oral cavity is spotted on a test paper holding a certain amount of acid.
- the program of the present invention may cause the computer to execute a step of displaying each parameter reflecting each risk as a numerical value, a figure, or a table based on the determined rank.
- the program of this invention may make a computer perform the step which displays a comment also about each parameter reflecting each risk based on the determined rank.
- the comment about a parameter explains the measurement result of each parameter, for example. Examples of comments on the parameters are: “There are few worms in saliva and it is in good condition.” “The acidity of saliva is near neutral. Let's keep this state by daily care.” “There is occult blood in saliva. There is a possibility of bleeding from the gingiva, and care is needed.” And “A salmon ammonia concentration is high and bacteria are actively breeding. Need care, "and so on.
- the reflectance data is measured in the measurement unit 21 and the measured reflectance data is stored in the measurement data storage unit 242, but instead of the measurement in the measurement unit 21,
- the result of the color reaction in the analysis tool of the present invention may be observed with the naked eye, and the subsequent processing may be performed using the result as reflectance data. That is, the progress of the color reaction in the analytical tool of the present invention can be observed under an arbitrary light source, and data for measuring each parameter can be acquired.
- the arbitrary light source may be, for example, natural light, a fluorescent light, an incandescent light bulb, or the like, or may be a light source limited to a specific wavelength. Therefore, in the present invention, the step of “measuring parameters” can be performed without using a detection device.
- each step may be executed by a single computer or may be executed by a plurality of physically independent computers.
- the measurement data may be transmitted to another device using an electric communication line or the like, and the risk level may be determined by the other device. Further, the determined risk level may be transmitted to another device using a telecommunication line or the like, and information such as a risk level determined by the other device and a comment based thereon may be displayed.
- the measurement data is input on the WEB
- the measurement data is transmitted to the risk level determination server
- the risk level is determined by the determination server
- the determination result is further executed. Can be illustrated on the WEB.
- a charging system based on data transmission / reception using a telecommunication line or the like may be employed.
- a billing system for example, there is a system that charges when a user displays a risk level judgment result on a WEB browser or when a file containing a risk level judgment result is downloaded. Can be mentioned. Charging can be performed by an arbitrary method such as a display / download pay-as-you-go system and a flat-rate system in which charging is performed according to a period such as day, week, or month.
- the program of the present invention may be provided by being recorded on a computer-readable recording medium.
- the computer-readable recording medium is such that information such as data and programs is accumulated by electrical, magnetic, optical, mechanical, chemical action, etc., and the accumulated information is read from the computer.
- a recording medium for example, floppy (registered trademark) disk, magneto-optical disk, CD-ROM, CD-R / W, DVD-ROM, DVD-R / W, DVD-RAM, DAT, 8 mm tape, memory
- a recording medium for example, floppy (registered trademark) disk, magneto-optical disk, CD-ROM, CD-R / W, DVD-ROM, DVD-R / W, DVD-RAM, DAT, 8 mm tape, memory
- a card a hard disk, a ROM (read only memory), an SSD, and the like.
- the program of the present invention may be recorded as a separate program for each step executed by the computer.
- the 2nd aspect of the program of this invention is a program which makes a computer perform the following steps (A) and (B).
- the 3rd aspect of the program of this invention is a program which makes a computer perform the following steps (A) and (B), for example.
- the 4th aspect of the program of this invention is a program which makes a computer perform the following steps (A) and (B), for example.
- a parameter reflecting the oral condition of the subject is measured, and based on the measurement result, the oral condition, that is, oral disease risk and / or oral hygiene condition Can be determined. That is, the present invention provides a method for determining the oral condition of a subject.
- a first aspect of the method of the present invention is a method for determining the oral condition of a subject, and includes the following (A), (B), and (C): It is the method of including.
- B A step of measuring one or more parameters reflecting the periodontal disease risk for a test sample obtained from the oral cavity and determining the level of periodontal disease risk using the measured parameter as an index.
- C A step of measuring one or more parameters reflecting oral cleanliness for a test sample obtained from the oral cavity, and determining the level of oral cleanliness using the measured parameters as an index.
- steps (A) to (C) may be executed simultaneously or individually.
- the second aspect of the method of the present invention is to measure two or more parameters reflecting caries risk for a test sample obtained from the oral cavity, and use the measured parameters as an index for caries risk.
- a method for determining a caries risk of a subject including a step of determining a level.
- the third aspect of the method of the present invention is, for example, for a test sample obtained from the oral cavity, measuring two or more parameters reflecting periodontal disease risk, and using the measured parameters as indices,
- a method for determining a periodontal disease risk comprising a step of determining a level of a periodontal disease risk.
- the fourth aspect of the method of the present invention is, for example, for a test sample obtained from the oral cavity, measuring two or more parameters reflecting oral cleanliness, and using the measured parameters as an index, It is a method of determining oral cleanliness including the step of determining the degree level.
- the method of the present invention is not particularly limited, but can be suitably implemented using, for example, the analysis tool, analysis device, program, etc. of the present invention described above.
- the description of the analysis tool, analysis apparatus, program, etc. of the present invention described above can be applied to the method of the present invention by changing where it should be changed.
- the method of the present invention may further include a step of displaying the determined level, and may include a step of displaying a comment based on the determined level, and the comment based on the measurement result of the parameter.
- the process of displaying may be included.
- the test sample obtained from the oral cavity is not particularly limited as long as the target parameter can be measured, for example, saliva at rest, gargle with purified water, or gum saliva collected by stimulation with gum Can be used.
- a rinse solution with purified water is preferable.
- the gargle with purified water can be obtained, for example, by containing 3 ml of purified water in the mouth for 10 seconds and discharging it into a container. The volume of purified water and the time for the mouth can be changed as needed.
- the obtained test sample can be used for subsequent operations without any special pretreatment.
- the test sample is spotted on an absorbent carrier that holds each measurement reagent provided on the test piece, or a sample that is provided in contact with the absorbent carrier that holds each measurement reagent. It is possible to directly react with each reagent for measurement by spotting on an absorbent carrier. However, when the quantitative determination of ammonia is performed by the micro-diffusion method, the absorbent carrier that holds the measurement reagent and the absorbent carrier that deposits the test sample are installed without being in contact with each other. The test sample is not in direct contact with the measurement reagent. Further, when each parameter is measured without using a test piece, for example, the color reaction can be advanced by adding a test sample to a liquid reaction system including an arbitrary parameter measurement reagent.
- the following procedure shows an example of a procedure in which a test sample is measured using a test piece of the present invention, a measuring apparatus of the present invention, and a program of the present invention, and a doctor or the like makes a diagnosis.
- a test sample obtained from the oral cavity a gargle with 3 ml of purified water is collected.
- the test sample was changed to each absorbent carrier of the test piece of the present invention or, if an absorbent carrier for spotting the sample was provided, spotted on the carrier and changed at a predetermined time.
- the color tone is measured with the measuring apparatus of the present invention.
- each risk level is judged and displayed. Furthermore, comments are displayed for each of caries risk, periodontal disease risk, and oral cleanliness based on each risk level. 4). Based on the displayed information, a doctor or the like diagnoses the subject's oral disease risk and oral hygiene status.
- an absorptive carrier for measuring mutans bacteria a test piece provided with an absorptive carrier prepared by immersing in a reagent solution for measuring mutans bacteria was used as a test group.
- the reagent solution contains 30 mM sucrose, 0.2% polyvinyl alcohol, 100 mM phosphate buffer (pH 6), 0.1 mM methoxy PMS, and 0.12 mM resazurin.
- the test piece which installed the absorbent carrier produced by immersing in the reagent solution which does not add methoxy PMS was used as a control group.
- each mutans bacterium level in the oral cavity was determined to be high, medium or low Hired.
- gargle liquid obtained from each subject by using 3 ml of purified water in the mouth for 10 seconds and discharging it into a container was used.
- a carrier containing methoxy PMS prepared in Test Example 1 was used as an absorptive carrier containing a reagent for measuring mutans bacteria.
- Tests for measuring pH, occult blood, white blood cell count and total protein concentration of commercially available AUTION Sticks (trade name, manufactured by ARKRAY, Inc.) as a carrier for measuring pH, occult blood, white blood cell count and total protein concentration Paper was diverted.
- As the acid buffering capacity measurement carrier 7 ⁇ l of 1 mM tartaric acid was spotted on one piece of pH measurement test paper of AUTION Sticks (trade name, manufactured by ARKRAY, Inc.) and dried.
- a carrier for measuring ammonia a commercially available carrier of Amicheck (trade name, manufactured by ARKRAY, Inc.) was diverted.
- a carrier for measuring calcium concentration a commercially available reagent pad of Spotchem II calcium (trade name, manufactured by ARKRAY, Inc.) was used.
- Each of the above carriers is affixed to a support carrier made of PET, and a test piece provided with reagents for measuring the number of mutans bacteria, pH, acid buffer capacity, occult blood volume, white blood cell count, ammonia concentration, total protein concentration, and calcium concentration Manufactured.
- the carrier for measuring the total protein concentration can be commonly used for determination of periodontal disease risk and determination of oral cleanliness.
- Example 2 Risk of oral disease and prediction of oral cleanliness by saliva testing system (1)
- the measurement results of the parameters used in the determination method of the present invention it was examined whether or not the diagnosis result of oral disease risk and cleanliness by the dentist can be predicted.
- DMFT is an index indicating caries experience, and is expressed as the total number of untreated caries, number of teeth lost due to caries, and number of teeth treated with caries in permanent teeth.
- CPI is an index indicating the necessity of treatment of periodontal disease, and is calculated based on a criterion obtained by scoring the test results of periodontal tissue using a WHO periodontal probe. For CPI, the upper and lower jaws were divided into six parts, the right molar part, the anterior tooth part, and the left molar part, and the average of the maximum values of each part was used for evaluation.
- OHI-DI is an index indicating the state of cleaning of the mouth, and is calculated based on a standard that scores the state of plaque deposition on the tooth surface. About OHI-DI, it divided into 6 site
- the prediction accuracy was improved by combining a plurality of saliva component measurement values corresponding to a certain oral condition (Table 4). Moreover, it became clear that prediction accuracy (multiple correlation coefficient) is further improved by combining personal data (Table 5). Moreover, it became clear that the prediction accuracy (multiple correlation coefficient) is further improved by combining the saliva component measurement value corresponding to one oral condition and the saliva component measurement value corresponding to another oral condition. (Table 6). Therefore, prediction accuracy is improved by a combination of saliva component measurement values and the like, and it is possible to determine caries risk, periodontal disease risk, and oral cleanliness with high accuracy.
- DNA was extracted from saliva using a DNA extraction kit (Nexttec), and three species known as periodontal disease representative bacteria, namely Porphyromonas gingivalis (Pg), Tannerella forsythensis (Tf), and Treponema
- Pg Porphyromonas gingivalis
- Tf Tannerella forsythensis
- Treponema The number of bacteria of denticola (Td) was measured by real-time PCR, and the total value was used for evaluation.
- the reaction composition and reaction conditions of real-time PCR were carried out under the conditions shown in Tables 7 and 8 for all bacterial species.
- Tables 9 and 10 show the sequences of the primers and TaqMan probes used.
- the number of colonies was counted after applying saliva diluted 100-10,000 times in MSB plate medium and culturing at 37 ° C under anaerobic conditions for 3 days.
- the total number of bacteria the number of colonies was counted after applying saliva diluted 10000 to 100,000 times in a blood plate medium and culturing at 37 ° C. under anaerobic conditions for 1 week.
- the composition of each medium is shown in Tables 11 and 12.
- the prediction accuracy was improved by combining a plurality of saliva component measurement values corresponding to a certain oral condition (Table 14). It was also revealed that the prediction accuracy (multiple correlation coefficient) was further improved by combining personal data (Table 15). Moreover, it became clear that the prediction accuracy (multiple correlation coefficient) is further improved by combining the saliva component measurement value corresponding to one oral condition and the saliva component measurement value corresponding to another oral condition. (Table 16). Therefore, prediction accuracy is improved by a combination of saliva component measurement values and the like, and it is possible to determine caries risk, periodontal disease risk, and oral cleanliness with high accuracy.
- parameters reflecting the oral condition that is, oral disease risk and / or oral hygiene condition can be measured, and the oral condition of the subject can be determined based on the measurement result.
- a plurality of components or properties reflecting the oral disease risk and oral hygiene state can be measured in a short time and once, and each risk level can be determined.
- a doctor or the like can objectively and comprehensively diagnose the oral disease risk and oral hygiene status of the subject based on the determined risk level. Therefore, the present invention is useful for performing diagnosis of oral hygiene and subsequent care guidance in one visit.
- control unit 231 ... risk level judging unit 231A ... rank judging Part 31B ⁇ risk level determination section 231C ⁇ risk level determination section 232 ... Comments determining section 24 ... storage unit 241 ... program storage unit 242 ... data storage unit
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Abstract
Description
以下の(A)、(B)、および(C)を備える分析用具。
(A)口腔から得られる被検試料について、う蝕リスクを反映する1またはそれ以上のパラメータを測定するための試薬。
(B)口腔から得られる被検試料について、歯周病リスクを反映する1またはそれ以上のパラメータを測定するための試薬。
(C)口腔から得られる被検試料について、口腔清潔度を反映する1またはそれ以上のパラメータを測定するための試薬。
[2]
前記分析用具が、支持担体と、該支持担体に担持される前記試薬を保持する吸収性担体とを備える試験片である、[1]に記載の分析用具。
[3]
前記う蝕リスクを反映するパラメータが、少なくともミュータンス菌数を含む、[1]または[2]に記載の分析用具。
[4]
う蝕リスクを反映するパラメータが、ミュータンス菌数、pH、及び酸緩衝能からなる群から選ばれるパラメータであり、
歯周病リスクを反映するパラメータが、カルシウム濃度、総タンパク質濃度、潜血量、及び白血球数からなる群から選ばれるパラメータであり、かつ
口腔清潔度を反映するパラメータが、アンモニア濃度及び総タンパク質濃度からなる群から選ばれるパラメータである、[1]~[3]のいずれかに記載の分析用具。
[5]
以下の(a)、(b)、及び(c)から選択される1またはそれ以上の特徴を有する、[1]~[4]のいずれかに記載の分析用具。
(a)前記う蝕リスクを反映するパラメータが、2またはそれ以上のパラメータからなる。
(b)前記歯周病リスクを反映するパラメータが、2またはそれ以上のパラメータからなる。
(c)前記口腔清潔度を反映するパラメータが、2またはそれ以上のパラメータからなる。
[6]
[1]~[5]のいずれかに記載の分析用具を使用して被検者の口腔状態を判定する方法であって、以下の(A)、(B)、および(C)を含む方法。
(A)口腔から得られる被検試料について、う蝕リスクを反映する1またはそれ以上のパラメータを測定し、測定されたパラメータを指標として、う蝕リスクのレベルを判定する工程。
(B)口腔から得られる被検試料について、歯周病リスクを反映する1またはそれ以上のパラメータを測定し、測定されたパラメータを指標として、歯周病リスクのレベルを判定する工程。
(C)口腔から得られる被検試料について、口腔清潔度を反映する1またはそれ以上のパラメータを測定し、測定されたパラメータを指標として、口腔清潔度のレベルを判定する工程。
[7]
さらに、判定されたレベルを表示する工程を含む、[6]に記載の方法。
[8]
さらに、判定されたレベルに基づきコメントを表示する工程を含む、[6]または[7]に記載の方法。
本発明は、口腔状態を反映するパラメータを測定するために好適に用いることができる分析用具を提供する。本発明の分析用具の第1の態様は、以下の(A)、(B)、および(C)を備える分析用具である。
(A)口腔から得られる被検試料について、う蝕リスクを反映する1またはそれ以上のパラメータを測定するための試薬、
(B)口腔から得られる被検試料について、歯周病リスクを反映する1またはそれ以上のパラメータを測定するための試薬、及び
(C)口腔から得られる被検試料について、口腔清潔度を反映する1またはそれ以上のパラメータを測定するための試薬。
ミュータンス菌数の測定は、特に制限されないが、例えば、レサズリンの還元反応を利用する方法やミュータンス菌に対する抗体を用いる方法により行うことができる。ミュータンス菌数の測定は、レサズリンの還元反応を利用する方法により行うのが好ましい。なお、このレサズリンの還元反応を利用する方法をレサズリン法とする。レサズリンは酸化還元指示薬であり、通常は酸化型の青色色素であるレサズリン(極大吸収波長605nm)として存在するが、ミュータンス菌を含むグラム陽性細菌の代謝により生じるNADHにより還元され、赤紫色色素(極大吸収波長573nm)であるレゾルフィンへと変換される。すなわち、ミュータンス菌の生菌数に応じてレサズリンの還元が進行する。また、レサズリン法を利用する場合の測定試薬は、レサズリンに加えて、さらに1-メトキシ-5-メチルフェナジニウムメチルサルフェート(メトキシPMS)を含有するのが好ましい。メトキシPMSを含有する場合には、含有しない場合と比較して、室温で短時間の反応条件で測定するのに有効である。試薬の濃度は適宜設定することが可能であるが、吸収性担体を浸漬する試薬溶液におけるメトキシPMSの濃度は、好ましくは0.1~1mMであり、より好ましくは0.1~0.5mMである。
(1)濾紙を、試薬溶液に浸漬する。当該試薬溶液は、30mMスクロース、0.2%ポリビニルアルコール、100mMリン酸緩衝液(pH6)、0.1mMメトキシPMS、及び0.12mMレサズリンを含有する。
(2)濾紙を、50℃で15分間乾燥させる。
(3)濾紙を5mm幅に切断する。
(4)断片をPETフィルムに貼付する。
(5)5mm幅に切断し、試験紙とする。
なお、上記手順において、試薬溶液の構成を他のパラメータ測定用の試薬構成に代えることにより、他のパラメータの測定用の吸収性担体を製造できることは言うまでもない。
唾液のpHは、特に制限されないが、例えば、pH指示薬により測定するのが好ましい。pH指示薬としては、既知の任意のpH指示薬を用いることができ、pH2~9の範囲に変色域を有するpH指示薬を用いるのが好ましく、pH3~8の範囲に変色域を有するpH指示薬を用いるのがより好ましい。また、pH指示薬としては、必要に応じて、複数のpH指示薬を混合して用いてもよく、例えば、ブロモクレゾールグリーンとブロモキシレノールブルーの複合試薬を好適に用いることができる。pH指示薬の濃度は適宜設定することが可能であるが、例えば、吸収性担体を浸漬する試薬溶液におけるブロモクレゾールグリーンの濃度は好ましくは0.1~0.6mM、より好ましくは0.1~0.4mMであり、ブロモキシレノールブルーの濃度は好ましくは0.6~2mM、より好ましくは0.8~1.8mMである。
唾液の酸緩衝能は、特に制限されないが、例えば、pH指示薬を用いて測定するのが好ましい。測定原理としては、あらかじめ酸性緩衝剤及びpH指示薬を含有させた吸収性担体に、被検試料を接触させることで、指示薬の指示pHが、酸緩衝能が高いほど唾液の本来のpHに近づき、低いほど唾液の本来のpHより酸性域に近づくことを利用する。pH指示薬としては、既知の任意のpH指示薬を用いることができ、pH2~9の範囲に変色域を有するpH指示薬を用いるのが好ましく、pH3~8の範囲に変色域を有するpH指示薬を用いるのがより好ましい。また、pH指示薬としては、必要に応じて、複数のpH指示薬を混合して用いてもよく、例えば、ブロモクレゾールグリーンとブロモキシレノールブルーの複合試薬を好適に用いることができる。酸性緩衝剤としては、例えば、不揮発性の有機酸を好ましく用いることができる。不揮発性の有機酸としては、例えばクエン酸、リンゴ酸、酒石酸、マロン酸、シュウ酸、スルホサリチル酸、スルフアニル酸、安息香酸、トリカルバリル酸が挙げられる。この中では、酒石酸がより好ましい。また、酸性緩衝剤としては、メタリン酸等の無機酸を用いることもできる。また、酸性緩衝剤としては、例えばフタル酸水素カリウムとリン酸カリウムの混合物等の緩衝剤であってもよい。試薬の濃度は適宜設定することが可能であるが、例えば、吸収性担体を浸漬する試薬溶液におけるブロモクレゾールグリーンの濃度は好ましくは0.1~0.6mM、より好ましくは0.1~0.4mMであり、ブロモキシレノールブルーの濃度は好ましくは0.6~2mM、より好ましくは0.8~1.8mMであり、酒石酸の濃度は好ましくは0.1~10mM、より好ましくは1~6mMである。
(1)濾紙を、試薬溶液に浸漬する。当該試薬溶液は、0.2mMブロモクレゾールグリーン、1.2mMブロモキシレノールブルー、0.05%ポリオキシエチレンソルビタンモノラウラート、0.5%ヒドロキシプロピルセルロース、2mM酒石酸を含有する。
(2)濾紙を、50℃で15分間乾燥させる。
(3)濾紙を5mm幅に切断する。
(4)断片をPETフィルムに貼付する。
(5)5mm幅に切断し、試験紙とする。
なお、上記手順において、試薬溶液の構成を他のパラメータ測定用の試薬構成に代えることにより、他のパラメータの測定用の吸収性担体を製造できることは言うまでもない。
カルシウム濃度の測定は、特に制限されないが、例えば、キレート法により行うのが好ましい。キレート法とは、カルシウムがキレート発色剤と結合すると色調が変化することを利用したカルシウム測定法である。キレート法としては、O-CPC法を用いるのが好ましい。O-CPC法とは、キレート発色剤としてオルト・クレゾールフタレイン・コンプレクソン(O-CPC)を用いた測定法であり、O-CPCは、アルカリ条件下でカルシウムと反応し深紅色のキレート化合物を生成する。
潜血の測定は、特に制限されないが、例えば、ヘモグロビン接触活性法により行うのが好ましい。ヘモグロビン接触活性法とは、血液成分であるヘモグロビン、ミオグロビン、又はそれらの分解産物が、過酸化物(ペルオキシド)等の酸素供与体から、酸素受容体に酸素の移動を触媒する能力(ペルオキシダーゼ様活性)を有することを利用したものである。酸素受容体として、酸化により色調の変化する指示薬を用いることで、その呈色反応を測定することによりヘモグロビン等の検出を通して潜血の検出が可能となる。
白血球数の測定は、特に制限されないが、例えば、白血球エステラーゼ法により行うのが好ましい。組織が炎症を起こした際には、白血球が増加するが、それに伴い白血球によるエステラーゼ産生もまた増大するためエステラーゼ活性を測定することで白血球数を算出できる。白血球エステラーゼ法とは、基質として用いたエステル化合物が白血球により産生されたエステラ-ゼ(白血球エステラーゼ)により加水分解されることで生じたアルコ-ル(フェノ-ル)成分を直接呈色させる、あるいは、ジアゾニウム塩とカップリングして呈色させることにより白血球数を測定する手法である。
総タンパク質濃度の測定は、特に制限されないが、例えば、タンパク誤差法により行うのが好ましい。タンパク誤差法とは、pH指示薬が、タンパク質の濃度に比例して、溶液の真のpHよりも高いpHを示すことを利用するタンパク質の測定法である。
アンモニアの定量は、特に制限されないが、例えば、好ましくは微量拡散法(コンウェイ法)により行われる。微量拡散法とは、アンモニア態窒素の定量に用いられる手法であり、試料から揮発する成分を吸収用溶液等にトラップし、それを比色等の手法により定量する手法である。アンモニア濃度の測定が微量拡散法により行われる場合には、本発明の試験片におけるアンモニア定量部位には、試薬を保持する吸収性担体(試薬層)とは別に、被検試料を点着する吸収性担体(試料層)が備えられ、両吸収性担体は互いに接触しないよう設置される。両吸収性担体は、例えば、細かい穴を設けたPET製フィルムを両吸収性担体間に挟むことで、互いに接触しないよう設置される。また、試料層はアルカリ緩衝剤、例えばホウ酸緩衝剤を保持する。試験片の試料層に被検試料を点着すると、試料層中のアルカリ緩衝剤が溶解して、試料はアルカリ性になる。試料中のアンモニウムイオンは、アルカリ条件下でアンモニア分子となり、アンモニアガスとして揮発し、例えばスペーサーの穴を通過して試薬層に移行する。試薬層中の指示薬がアンモニアガスと反応して発色する。
乳酸脱水素酵素活性の測定は、特に制限されないが、例えば、ホルマザン法により行われる。ホルマザン法とは、乳酸脱水素酵素がNADを補酵素とし、乳酸を酸化して生成されたNADHにより、ジアホラーゼを解してテトラゾリウム塩を呈色物質であるホルマザンに還元させる手法である。テトラゾリウム塩としては例えば、テトラゾリウムバイオレットを好適に用いることができる。
アルカリフォスファターゼ活性の測定は、特に限定されないが、例えば、p-ニトロフェニルリン酸法により行われる。p-ニトロフェニルリン酸法とは、アルカリフォスファターゼが基質であるp-ニトロフェニルリン酸を加水分解して生成される、呈色物質であるp-ニトロフェノールを定量する手法である。
本発明の測定装置の第1の態様は、(A)口腔から得られる被検試料について、う蝕リスクを反映する1またはそれ以上のパラメータ、歯周病リスクを反映する1またはそれ以上のパラメータ、及び口腔清潔度を反映する1またはそれ以上のパラメータを測定する測定部、(B)測定部で測定された結果から、う蝕リスク、歯周病リスク、及び口腔清潔度のレベルを判定するリスクレベル判定部、(C)リスクレベル判定部で判定されたリスクレベルを文字、図形、記号、色彩又はこれらの結合として表示する表示部を備える測定装置である。本発明の測定装置は、さらに(D)リスクレベル判定部で判定されたリスクレベルに基づき、コメントを表示する表示部、を備える測定装置である。以下、本発明の測定装置について、図面を参照して説明する。図3は、本発明の測定装置の一実施形態である測定装置2の機能を示すブロック図である。
(A)口腔から得られる被検試料について、う蝕リスクを反映する2またはそれ以上のパラメータを測定する測定部、
(B)測定部で測定された結果から、う蝕リスクのレベルを判定するリスクレベル判定部、
(C)リスクレベル判定部で判定されたう蝕リスクレベルを表示する表示部。
(A)口腔から得られる被検試料について、歯周病リスクを反映する2またはそれ以上のパラメータを測定する測定部、
(B)測定部で測定された結果から、歯周病リスクのレベルを判定するリスクレベル判定部、
(C)リスクレベル判定部で判定された歯周病リスクレベルを表示する表示部。
(A)口腔から得られる被検試料について、口腔清潔度を反映する2またはそれ以上のパラメータを測定する測定部、
(B)測定部で測定された結果から、口腔清潔度のレベルを判定するリスクレベル判定部、
(C)リスクレベル判定部で判定された口腔清潔度のレベルを表示する表示部。
本発明のプログラムの第1の態様は、以下のステップ(A)および(B)をコンピュータに実行させるプログラムである。
(A)口腔から得られる被検試料について、う蝕リスクを反映する1またはそれ以上のパラメータ、歯周病リスクを反映する1またはそれ以上のパラメータ、及び口腔清潔度を反映する1またはそれ以上のパラメータの測定結果に基づき、う蝕リスク、歯周病リスク、及び口腔清潔度のレベルをレベル判定部に判定させるステップ、
(B)ステップ(A)で判定されたレベルを表示部に表示させるステップ。
(C)ステップ(A)で判定されたレベルに基づき、コメントを表示部に表示させるステップ。
tm ≧ x > tm+1 ・・・(i)
を満たすmが算出され(ただし、tn ≧ x の時、x = n)、該パラメータのランクはn段階中のm段階目であると判定される。
z = pmax + 1 ・・・(ii)
で算出される(ただし、pmax = nの場合、z=nとする)。なお、任意のパラメータについて判定されたランクが、複数の段階のリスクレベルに対応している場合、対応するリスクレベルの内、最大の値をpとして用いる。例えば、リスクレベルが6段階で、ミュータンス菌数のランクが対応するリスクレベルが4、pHのランクが対応するリスクレベルが2、酸緩衝能のランクが対応するリスクレベルが3であった場合、3つの内で最大であるミュータンス菌数のランクが対応するリスクレベルを用いて、う蝕リスクのリスクレベルは4+1=5であると算出される。
(A)口腔から得られる被検試料について、う蝕リスクを反映する2またはそれ以上のパラメータの測定結果に基づき、う蝕リスクのレベルをリスクレベル判定部に判定させるステップ、
(B)ステップ(A)で判定されたレベルを表示部に表示させるステップ。
(A)口腔から得られる被検試料について、歯周病リスクを反映する2またはそれ以上のパラメータの測定結果に基づき、歯周病リスクのレベルをリスクレベル判定部に判定させるステップ、
(B)ステップ(A)で判定されたレベルを表示部に表示させるステップ。
(A)口腔から得られる被検試料について、口腔清潔度を反映する2またはそれ以上のパラメータの測定結果に基づき、口腔清潔度のレベルをリスクレベル判定部に判定させるステップ、
(B)ステップ(A)で判定されたレベルを表示部に表示させるステップ。
本発明においては、例えば上記に示すように、被検者の口腔状態を反映するパラメータを測定し、測定結果に基づき口腔状態、すなわち口腔疾患リスクおよび/または口腔衛生状態を判定することができる。すなわち、本発明は、被検者の口腔状態を判定する方法を提供する。
(A)口腔から得られる被検試料について、う蝕リスクを反映する1またはそれ以上のパラメータを測定し、測定されたパラメータを指標として、う蝕リスクのレベルを判定する工程。
(B)口腔から得られる被検試料について、歯周病リスクを反映する1またはそれ以上のパラメータを測定し、測定されたパラメータを指標として、歯周病リスクのレベルを判定する工程。
(C)口腔から得られる被検試料について、口腔清潔度を反映する1またはそれ以上のパラメータを測定し、測定されたパラメータを指標として、口腔清潔度のレベルを判定する工程。
1.口腔から得られる被検試料として、3mlの精製水によるうがい液を採取する。
2.被検試料を、本発明の試験片の各吸収性担体に、あるいは試料を点着するための吸収性担体が備えられている場合には当該担体に点着して、所定の時間で変化した色調を本発明の測定装置で測定する。
3.測定結果に基づき、各リスクレベルを判定し、表示する。さらに、各リスクレベルに基づき、う蝕リスク、歯周病リスク、及び口腔清潔度のそれぞれについてコメントを表示する。
4.表示された情報に基づき、医師等が被検者の口腔疾患リスク、及び口腔衛生状態を診断する。
レサズリンの還元を指標としたミュータンス菌の定量キットとしては、昭和薬品化工株式会社のRDテスト「昭和」(商品名)が知られているが、37℃、15分の培養操作が必要であった。そこで、本試験例においては、室温5分間でのミュータンス菌の測定を目指し、レサズリン法によるミュータンス菌の検出条件について検討した。
<試験片の作成>
ミュータンス菌の測定用試薬を含む吸収性担体としては、試験例1で作製したメトキシPMSを含む担体を利用した。pH、潜血、白血球数、総タンパク質濃度の測定用担体としては、市販されているオーションスティックス(商品名、アークレイ株式会社製)のpH、潜血、白血球数、総タンパク質濃度を測定対象とする試験紙を転用した。酸緩衝能測定用担体としては、オーションスティックス(商品名、アークレイ株式会社製)のpH測定用試験紙1片に1mM酒石酸を7μl点着し、乾燥させたものを用いた。アンモニア測定用担体としては、市販されているアミチェック(商品名、アークレイ株式会社製)の担体を転用した。カルシウム濃度測定用担体としては、市販されているスポットケム II カルシウム(商品名、アークレイ株式会社製)の試薬パッドを転用した。上記の各担体を、PET製支持担体に貼り付け、ミュータンス菌数、pH、酸緩衝能、潜血量、白血球数、アンモニア濃度、総タンパク質濃度、およびカルシウム濃度測定用の試薬を備える試験片を製造した。なお、総タンパク質濃度の測定用担体は、歯周病リスクの判定および口腔清潔度の判定に共通に利用できる。
本実施例では、本発明の判定方法に用いられるパラメータの測定結果に基づき、歯科医による口腔疾患リスクおよび口腔清清潔度の診断結果を予測できるかを検討した。
(口腔指標評価)
う蝕リスク、歯周病リスク、口腔清潔度に関する口腔指標として、以下の項目を用いた。
・う蝕状態リスク:DMFT
・歯周病状態リスク:CPI
・口腔清潔度:OHI-DI
蒸留水(日本薬局方注射用水)3mLを口に含み、約10秒間洗口後、吐出したものを被検試料とした。実施例1で作成した試験片に備えられた各吸収性担体に被検試料を10uLずつ点着後、唾液成分を測定した。測定は、検出機器としてポケットケムUA PU-4010(アークレイ株式会社製)を用い、室温下、表2の条件で行った。なお、ミュータンス菌数の測定は、被検試料を点着してから1分後と5分後に反射率を測定し、4分間での反射率変化を算出することにより行った。また、それ以外の測定項目は、被検試料を点着してから表2に記載の測定時間経過後に反射率を測定することにより行った。なお、アンモニア濃度の測定は、被検試料を点着して10秒後に試料層とスペーサーを試薬層から剥離させ、60秒後に試薬層の反射率を測定することにより行った。
協力者231名のデータを用いて解析を実施した。解析は、各口腔指標を目的変数とし、唾液成分測定値(反射率データ)を説明変数として単回帰分析を実施した(表3)。さらに、説明変数として、複数の唾液成分測定値を組み合わせた場合と、年齢や性別や喫煙有無の個人データを組み合わせた場合について、重回帰分析を実施した(表4、5、6)。尚、性別や喫煙有無といった質的変数についてはダミー変数として扱った。それぞれの回帰分析を実施後、重相関係数を求め、これを予測精度として評価した。解析は、解析ソフトJMP5.0(SAS Institute, Japan)を用いて実施した。
各唾液成分測定値を説明変数とした単回帰分析の結果、いずれの測定値についても対応する口腔状態との相関が認められ(表3)、唾液成分測定値(反射率データ)から各口腔状態を予測することが可能であることが明らかとなった。よって、う蝕リスク、歯周病リスク、および口腔清潔度のそれぞれを反映する少なくとも1つのパラメータを測定することで、う蝕リスク、歯周病リスク、口腔清潔度をまとめて簡便に判定することが可能である。
<方法>
(口腔指標評価)
う蝕、歯周病、口腔清潔度に関する口腔指標として、以下の項目を用いた。
・う蝕リスク:唾液中う蝕菌数
・歯周病リスク:唾液中歯周病菌数
・口腔清潔度:唾液中総菌数
蒸留水(日本薬局方注射用水)3mLを口に含み、約10秒間洗口後、吐出したものを被検試料とした。試験片に備えられた各吸収性担体に被検試料を10uLずつ点着後、唾液成分を測定した。測定は、検出機器としてポケットケムUA PU-4010(アークレイ株式会社製)を用い、室温下、表2の条件で行った。なお、ミュータンス菌数の測定は、被検試料を点着してから1分後と5分後に反射率を測定し、4分間での反射率変化を算出することにより行った。また、それ以外の測定項目は、被検試料を点着してから表2に記載の測定時間経過後に反射率を測定することにより行った。なお、アンモニア濃度の測定は、被検試料を点着して10秒後に試料層とスペーサーを試薬層から剥離させ、60秒後に試薬層の反射率を測定することにより行った。
(統計解析)
協力者231名のデータを用いて解析を実施した。解析は、各口腔指標を目的変数とし、唾液成分測定値(反射率データ)を説明変数として単回帰分析を実施した(表13)。さらに、説明変数として、複数の唾液成分測定値を組み合わせた場合と、年齢や性別や喫煙有無の個人データを組み合わせた場合について、重回帰分析を実施した(表14、15、16)。尚、性別や喫煙有無といった質的変数についてはダミー変数として扱った。それぞれの回帰分析を実施後、重相関係数を求め、これを予測精度として評価した。解析は、解析ソフトJMP5.0(SAS Institute, Japan)を用いて実施した。
各唾液成分測定値を説明変数とした単回帰分析の結果、いずれの測定値についても対応する口腔状態との相関が認められ(表13)、唾液成分測定値(反射率データ)から各口腔状態を予測することが可能であることが明らかとなった。よって、う蝕リスク、歯周病リスク、および口腔清潔度のそれぞれを反映する少なくとも1つのパラメータを測定することで、う蝕リスク、歯周病リスク、口腔清潔度をまとめて簡便に判定することが可能である。
10・・・支持担体
11・・・う蝕リスク測定部
11A、11B、11C・・・う蝕リスクを反映するパラメータを測定するための試薬を保持する吸収性担体
12・・・歯周病リスク測定部
12A、12B、12C・・・歯周病リスクを反映するパラメータを測定するための試薬を保持する吸収性担体
13・・・口腔清潔度測定部
13A、13B・・・口腔清潔度を反映するパラメータを測定するための試薬を保持する吸収性担体
14A、15A・・・任意のパラメータを測定するための試薬を保持する吸収性担体
14B、15B・・・被検試料を点着する吸収性担体
15C・・・スペーサー
2・・・測定装置
21・・・測定部
22・・・表示部
23・・・制御部
231・・・リスクレベル判定部
231A・・・ランク判定部
231B・・・リスクレベル判定部
231C・・・リスクレベル判定部
232・・・コメント判定部
24・・・記憶部
241・・・プログラム記憶部
242・・・データ記憶部
Claims (8)
- 以下の(A)、(B)、および(C)を備える分析用具。
(A)口腔から得られる被検試料について、う蝕リスクを反映する1またはそれ以上のパラメータを測定するための試薬。
(B)口腔から得られる被検試料について、歯周病リスクを反映する1またはそれ以上のパラメータを測定するための試薬。
(C)口腔から得られる被検試料について、口腔清潔度を反映する1またはそれ以上のパラメータを測定するための試薬。 - 前記分析用具が、支持担体と、該支持担体に担持される前記試薬を保持する吸収性担体とを備える試験片である、請求項1に記載の分析用具。
- 前記う蝕リスクを反映するパラメータが、少なくともミュータンス菌数を含む、請求項1または2に記載の分析用具。
- う蝕リスクを反映するパラメータが、ミュータンス菌数、pH、及び酸緩衝能からなる群から選ばれるパラメータであり、
歯周病リスクを反映するパラメータが、カルシウム濃度、総タンパク質濃度、潜血量、及び白血球数からなる群から選ばれるパラメータであり、かつ
口腔清潔度を反映するパラメータが、アンモニア濃度及び総タンパク質濃度からなる群から選ばれるパラメータである、請求項1~3のいずれか1項に記載の分析用具。 - 以下の(a)、(b)、及び(c)から選択される1またはそれ以上の特徴を有する、請求項1~4のいずれか1項に記載の分析用具。
(a)前記う蝕リスクを反映するパラメータが、2またはそれ以上のパラメータからなる。
(b)前記歯周病リスクを反映するパラメータが、2またはそれ以上のパラメータからなる。
(c)前記口腔清潔度を反映するパラメータが、2またはそれ以上のパラメータからなる。 - 請求項1~5のいずれか1項に記載の分析用具を使用して被検者の口腔状態を判定する方法であって、以下の(A)、(B)、および(C)を含む方法。
(A)口腔から得られる被検試料について、う蝕リスクを反映する1またはそれ以上のパラメータを測定し、測定されたパラメータを指標として、う蝕リスクのレベルを判定する工程。
(B)口腔から得られる被検試料について、歯周病リスクを反映する1またはそれ以上のパラメータを測定し、測定されたパラメータを指標として、歯周病リスクのレベルを判定する工程。
(C)口腔から得られる被検試料について、口腔清潔度を反映する1またはそれ以上のパラメータを測定し、測定されたパラメータを指標として、口腔清潔度のレベルを判定する工程。 - さらに、判定されたレベルを表示する工程を含む、請求項6に記載の方法。
- さらに、判定されたレベルに基づきコメントを表示する工程を含む、請求項6または7に記載の方法。
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Also Published As
Publication number | Publication date |
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EP2660597A4 (en) | 2014-12-03 |
CN103282774B (zh) | 2015-08-05 |
CN103282774A (zh) | 2013-09-04 |
KR101958699B1 (ko) | 2019-03-15 |
JPWO2012090995A1 (ja) | 2014-06-05 |
KR20140027922A (ko) | 2014-03-07 |
US9500649B2 (en) | 2016-11-22 |
JP5981350B2 (ja) | 2016-08-31 |
US20150038350A1 (en) | 2015-02-05 |
EP2660597B1 (en) | 2017-09-13 |
EP2660597A1 (en) | 2013-11-06 |
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